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Cancelation/Refund/Transfer/Schedule Change Policy: Patron requested refunds or transfers will be approved only if initiated no later than 10 business days prior to the first day of class. All refunds/transfers will be charged a processing fee of $17 per class. Refunds will not be granted after the first class meeting except in the case of medical emergency. Cancellations, transfers, and schedule changes will not be granted for non-attendance. Refund requests must be made in writing to: City of El Cerrito, 7007 Moeser Lane, El Cerrito, CA 94530. Or by fax to (510) 528-9413 or by email to [EMAIL REDACTED] Liability Release: To the extent permitted by law, I hereby absolve the City of El Cerrito, its employees and volunteers from all liability that may arise as the result of my participation in the activities mentioned on this sheet, and, if the above named participant is a minor, I hereby give my permission for his/her participation as indicated and in so doing absolve the City of El Cerrito, its employees and volunteers from such liability. I realize that the City of El Cerrito is not responsible for lost or stolen articles. I understand that participants in the City of El Cerrito programs do so at their own risk and the City does not provide accident insurance. Participant/Parent/Guardian Signature Date Signature indicates agreement to and understanding of policies and releases listed above. Photo Release: I acknowledge that the City of El Cerrito takes photographs and videotapes of its activities and events for publicity purposes and authorize the use of my image or my child’s image by the City for such purposes. I understand I will not be compensated for use of photos or videos. Nut Allergy Policy: There are children in our program with food allergies. Please do not send any snack, lunch or other food items with your child made with nuts or cooked in nut oils. Behavior Policy: I understand that my child is expected to follow all rules established by his or her instructor, and any failure to comply may result in dismissal from the program. I also understand that no refunds will be given. A copy of our policy is available upon request. Emergency Procedure: I understand that in the case of a medical emergency, 911 will be called and that the participant may be transported by ambulance to a nearby hospital at the discretion of emergency personnel. Every effort will be made to contact the emergency contact listed on the form. • Registration form is limited to family members only! • Use one line for each person or course 0315 Pay with card on file: q_ I authorize the City of El Cerrito to charge my credit card on file ending in Exp / Signature Donate to the David Hunter Scholarship Fund $ Household Registration If you are new to El Cerrito Recreation Programs, please complete the entire form. For returning participants, if your household information has NOT changed please check here o. Otherwise please complete any updates below. Birth Date Gender Cell phone Primary/Adult Last Name First Name (mm/dd/yy) (M/F) number Street Address City Zip Home Phone ( ) Bus. Phone ( ) Email Cell ( ) Emergency Contact Phone ( ) Participant Birth Date Gender First & Last Name Class title Activity # Section # (mm/dd/yy) (M/F) 1. 2. 3. City of El Cerrito Recreation Department Summer 2015 Community Center: 7007 Moeser Lane, El Cerrito, CA 94530 www.el-cerrito.org/recreation • Fax to (510) 528-9413 or email to [EMAIL REDACTED] SUBMIT FORM ---PAGE BREAK--- City of El Cerrito Recreation Department Summer 2015 Community Center: 7007 Moeser Lane, El Cerrito, CA 94530 www.el-cerrito.org/recreation • Fax to (510) 528-9413 or email to [EMAIL REDACTED] Refunds, Cancellations & Transfers Refund/Transfer requests will be approved only if initiated in writing no later than 10 business days prior to the first day of class. All refunds/ transfers will be charged a processing fee of $17 per course session. Refunds will not be granted after the first class meeting except in the case of a medical emergency. Refunds will be considered only upon receipt of a doctor’s note and the completion of a “Cancellation Form”, unless the class is cancelled by the instructor. Refund requests must be made in writing to: City of El Cerrito, 7007 Moeser Lane, El Cerrito, CA 94530. Or faxed to (510) 528-9413 or emailed to [EMAIL REDACTED] Registration In Person Walk-in registration is accepted at the Recreation Department office during business hours Monday, Wednesday, & alternate Fridays 8:00am-5:00pm, Tuesday & Thursday 8:00am-6:00pm. The office is located at 7007 Moeser Lane, El Cerrito. Please see page 2 for a list of the Fridays the office is closed. Register Online You can register online for your favorite classes and activities anytime, day or night, from your home or office computer. Most recreation and swim classes are available for online registration. There is no additional charge for online registration. Detailed instructions are online, see below: Returning Participants If you registered for a class, program, membership or rental you have a temporary user name and password, which can be found at the top of your registration receipt. The first time you log in, enter your Household ID for both the User Name and the Password. For your security, you will be prompted to change your user information. If you do not have a receipt and do not know your user name and password, please contact us at [EMAIL REDACTED] or (510) 559-7000 for assistance. New Participants To enroll in programs and pay online, register for an online account by creating a User Name and Password. How To Find the activities you want to register for in the brochure. Go to our web site and click the “El Cerrito Recreation Online Registration Link”. Online registration instructions are on this page. Complete the registration process pay with a credit card, and receive an instant e-mail confirmation of your enrollment. Go to our web site today and register online www.el-cerrito.org/recreation Fax In Your Registration (510) 528-9413 Fax a completed registration form from this brochure, along with credit card authorization. Visa, MasterCard, and American Express accepted. You Can Mail Us Send a completed registration form, from this brochure, along with credit card authorization, a check or money order. Please do not send cash. Your check will be returned if the activity for which you are registering is full. However, you will be placed on a waiting list for that activity. Please note that a $25 fee will be charged on all returned checks. El Cerrito Recreation Department, 7007 Moeser Lane, El Cerrito, CA 94530 Fees and Material Fees The fees listed are resident and non-resident rates. Fees are subject to change. Material fees are paid directly to the instructor on the first day of class. If a class does not indicate a material fee, a supply list may be discussed at the first meeting.